COVID-19 in People Living with HIV

Rutgers expert explains why COVID-19 pandemic poses additional difficulties, risks to people with HIV

Newswise — Stephanie Shiau, an HIV/AIDS researcher at the Rutgers School of Public Health says those living with the chronic illness who are infected with COVID-19 may be at a greater risk for physiological, social and psychological problems during this global pandemic.

The instructor in the Department of Biostatistics and Epidemiology at the School of Public Health, who recently authored a paper in the journal AIDS and Behavior, talks about how the COVID-19 pandemic may affect those with HIV.

Are people with HIV at a greater risk for contracting and dying from COVID-19?

In March 2020, the Centers for Disease Control and Prevention said people with HIV may be at a higher risk for severe cases of coronavirus disease because many patients with HIV are older and have other underlying health conditions. There was particular concern for people with HIV who are not receiving treatment or are experiencing advanced stages of HIV with a low CD4 cell count. However, there is limited evidence that people with HIV are at a greater risk of COVID-19 infection compared to the general population.

Does HIV anti-viral medication offer protection from COVID-19?

One hypothesis is that certain types of antiretroviral therapy used to prevent and treat HIV may provide some protection from acquiring and/or experiencing more severe cases of COVID-19. Research is underway, with some laboratory studies showing that some HIV medications are associated with an improved response against other coronaviruses, but not in patients with severe cases of COVID-19. Another HIV antiviral medication is being studied as a potential treatment for COVID-19. However, people with HIV should remain in communication with their health care providers and should not switch medications in an attempt to prevent or treat COVID-19.

Does the age of a person with HIV affect their vulnerability to more severe cases of COVID-19?

In the United States, there are approximately 1.2 million people with HIV, more than half of whom are over 50. Older age and underlying health conditions, such as high blood pressure, diabetes and chronic lung disease, are risk factors for more severe cases of COVID-19. Additionally, social distancing and self-isolation may be difficult for older adults with HIV as they may experience higher rates of loneliness and rely more on social networks.

What other challenges does the pandemic create for people living with HIV?

Individuals with HIV often have physical, psychological and social conditions that require ongoing and frequent contact with health care providers. With social distancing, it may be hard for them to access the care they need even through telemedicine. For example, there is a risk of interruptions in HIV treatment due to drop-offs in drug production. And lack of access to drugs that reduce the viral load of HIV may lead to increased risk of developing opportunistic infections and/or transmitting HIV to others. People with HIV who achieve and maintain an undetectable viral load cannot sexually transmit HIV to others; this is known as “Undetectable=Untransmittable” or “U=U.”

It is crucial that people with HIV stay in contact with their health care providers during the COVID-19 pandemic, and it will be important to document the extent to which the COVID-19 pandemic has interfered with HIV care.

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